The value of T2-weighted MRI contrast ratio combined with DWI in evaluating the pathological grade of solid lung adenocarcinoma

AIM

To assess the predictive value of T2-weighted (T2W) magnetic resonance imaging (MRI) in combination with diffusion-weighted imaging (DWI) for determining the pathological grading of solid lung adenocarcinoma.

MATERIALS AND METHODS

The clinical and imaging data from 153 cases of solid lung adenocarcinoma (82 men, 71 women, mean age 63.2 years) confirmed at histopathology in The First Affiliated Hospital of Xi'an Jiaotong University from January 2017 to May 2022 were analysed retrospectively. Adenocarcinomas were classified into low-grade (G1 and G2) and high-grade (G3) groups following the 2020 pathological grading system proposed by the International Association for the Study of Lung Cancer. The T2-weighted contrast ratio (T2CR), calculated as the T2 signal intensity of the lung mass/nodule divided by the T2 signal intensity of the right rhomboid muscle was utilised. Two experienced radiologists reviewed the MRI images independently, measured the T2CR, and obtained apparent diffusion coefficient (ADC) values. The Mann-Whitney U-test was used to compare general characteristics (sex, age, maximum diameter), T2CR, and ADC values between the low-grade and high-grade groups. The non-parametric Kruskal-Wallis test determined differences in T2CR and ADC values among the five adenocarcinoma subtypes. Receiver characteristic curve (ROC) analysis, along with area under the curve (AUC) calculation, assessed the effectiveness of each parameter in distinguishing the pathological grade of lung adenocarcinoma. A Z-test was used to compare the AUC values.

RESULTS

Among the 153 patients with adenocarcinoma, 103 had low-grade adenocarcinoma, and 50 had high-grade adenocarcinoma. The agreement between T2CR and ADC observers was good (0.948 and 0.929, respectively). None of the parameters followed a normal distribution (p<0.05). The ADC value was lower in the high-grade adenocarcinoma group compared to the low-grade adenocarcinoma group (p=0.004), while the T2CR value was higher in the high-grade group (p=0.011). Statistically significant differences were observed in maximum diameter and gender between the two groups (p<0.001 and p=0.005, respectively), while no significant differences were noted in age (p=0.980). Among the five adenocarcinoma subtypes, only the lepidic and micropapillary subtypes displayed statistical differences in ADC values (p=0.047), with the remaining subtypes showing no statistical differences (p>0.05). The AUC values for distinguishing high-grade adenocarcinoma from low-grade adenocarcinoma were 0.645 for ADC and 0.627 for T2CR. Combining T2CR, ADC, sex, and maximum diameter resulted in an AUC of 0.778, sensitivity of 70%, and specificity of 75%. This combination significantly improved diagnostic efficiency compared to T2CR and ADC alone (p=0.008, z = 2.624; p=0.007, z = 2.679).

CONCLUSION

The MRI quantitative parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma, offering valuable insights for precise lung cancer treatment.

Nanotechnological advances in the treatment of epilepsy: a comprehensive review

Epilepsy is one of the most prevalent chronic neurological disorders characterized by frequent unprovoked epileptic seizures. Epileptic seizures can develop from a broad range of underlying abnormalities such as tumours, strokes, infections, traumatic brain injury, developmental abnormalities, autoimmune diseases, and genetic predispositions. Sometimes epilepsy is not easily diagnosed and treated due to the large diversity of symptoms. Undiagnosed and untreated seizures deteriorate over time, impair cognition, lead to injuries, and can sometimes result in death. This review gives details about epilepsy, its classification on the basis of International League Against Epilepsy, current therapeutics which are presently offered for the treatment of epilepsy. Despite of the fact that more than 30 different anti-epileptic medication and antiseizure drugs are available, large number of epileptic patients fail to attain prolonged seizure independence. Poor onsite bioavailability of drugs due to blood brain barrier poses a major challenge in drug delivery to brain. The present review covers the limitations with the state-of-the-art strategies for managing seizures and emphasizes the role of nanotechnology in overcoming these issues. Various nano-carriers like polymeric nanoparticles, dendrimers, lipidic nanoparticles such as solid lipid nanoparticles, nano-lipid carriers, have been explored for the delivery of anti-epileptic drugs to brain using oral and intranasal routes. Nano-carries protect the encapsulated drugs from degradation and provide a platform to deliver controlled release over prolonged periods, improved permeability and bioavailability at the site of action. The review also emphasises in details about the role of neuropeptides for the treatment of epilepsy.

Nose to Brain Delivery of Transferrin conjugated PLGA nanoparticles for clonidine

The present work focuses on the development of surface modified transferrin PLGA nanoparticles loaded with clonidine for nose to brain delivery. The CLD-Tf-PLGA-NPs were developed using double emulsification, followed by solvent evaporation and characterization. Particle size, PDI and Zeta potential of the nanoparticles was 199.5 ± 1.36 nm, 0.291, -17.4 ± 6.29 mV respectively with EE% 86.2 ± 2.12 %, and DL%, 7.8 ± 0.48 %. TEM, SEM and FTIR analysis were carried out to confirm the size and transferrin coating over the surface of nanoparticles. In-vitro drug release profile were studied in PBS (pH 7.4) and SNF (pH 5.5) for 72 h and highest release was observed in PBS 89.54 ± 3.17 %. Cellular assays were conducted on Neuro-2a cells to check the cytotoxicity and uptake of Tf-modified PLGA nanoparticles and the cell viability% was obtained to be 61.85 ± 4.48 % even at maximum concentration (40Cmax) with uptake of approximately 97 %. Histopathological studies were also performed to identify the cytotoxicity on nasal epithelium along with in-vivo biodistribution and pharmacodynamics studies to assess the concentration of drug in the mice brain and behavioural responses after intranasal delivery of surface modified nanoparticles. The results showed significant increase in concentration of drug in brain and behavioural improvements in mice (p < 0.05).

Polysorbate 80 surface modified PLGA nanoparticles: an in-vitro evaluation of cellular uptake and cytotoxicity on neuro-2a cells

AIM

Present study focuses on the development of P80 coated PLGA Nanoparticles loaded with drugs, paroxetine (P80-Par-PLGA-NPs) and clonidine (P80-CLD-PLGA-NPs) for in-vitro evaluation of Cellular Uptake & Cytotoxicity on Neuro-2a cells.

METHOD

P80-Par-PLGA-NPs and P80-CLD-PLGA-NPs were developed and characterised for zeta size, potential, PDI, EE%, DL%, TEM, SEM, FTIR, DSC, in-vitro release, cytotoxicity, histopathological and cell uptake studies using rhodamine loaded P80-NPs.

RESULT

Mean particle diameter of P80-Par-PLGA-NPs and P80-CLD-PLGA-NPs was 204; 182.7 nm, ZP of -21.8; -18.72 mV and 0.275; 0.341 PDI, respectively. TEM and SEM images revealed homogenous surface morphology. In-vitro drug release showed sustained and complete release in 72 h. Cell viability (>90%) at Cmax and no cytotoxicity in histopathology was observed. Significant higher uptake (96.9%) of P80-modified-NPS was observed as compared to unmodified-NPs (81%) (p < 0.05).

CONCLUSION

The finding clearly indicated a higher cell uptake of drugs via surface modified P80-coated PLGA-NPs as compared to unmodified particles.

Evaluation of Enhanced Cytotoxicity Effect of Repurposed Drug Simvastatin/ Thymoquinone Combination against Breast Cancer Cell Line

INTRODUCTION

The repurposing of drugs for their anticancer potential is gaining a lot of importance in drug discovery.

AIMS

The present study aims to explore the potential of Simvastatin (SIM), a drug used in the treatment of high cholesterol, and thymoquinone (Nigella Sativa) (THY) for its anti-cancer activity on breast cancer cell lines. Thymoquinone is reported to have many potential medicinal properties exhibiting antioxidant, antiinflammatory, anti-cancer, and activities like tissue growth and division, hormone regulation, immune response and development, and cell signaling.

METHODS

In this analysis, we explored the inhibitory effects of the combination of simvastatin ad thymoquinone on two breast cancer cell lines viz MCF-7 and MDA-MB-231 cells. The combined effect of simvastatin ad thymoquinone on cell viability, colony formation, cell migration, and orientation of more programmed cell death in vitro was studied. Cell cycle arrest in the G2/M phase was concomitant with the combined effect of SIM and THY persuading apoptosis and generating reactive oxygen species (ROS).

RESULTS

The cell cycle arrest in combined treatment was 8.1% on MCF-7 cells and 3.8 % for MDA-MB-231 cells an increased apoptosis was observed when cells were treated in combination which was about 76.20% and 58.15 % respectively for MCF-7 and MDA-MB-231 cells.

CONCLUSION

It was concluded that the combined effect of simvastatin and thymoquinone stimulates apoptosis in breast cancer cells.

Nanocarrier-Based Drug Delivery to Brain: Interventions of Surface Modification

Brain disorders are a prevalent and rapidly growing problem in the medical field as they adversely affect the quality of life of a human. With an increase in life expectancy, it has been reported that diseases like Alzheimer's, Parkinson's, stroke and brain tumors, along with neuropsychological disorders, are also being reported at an alarmingly high rate. Despite various therapeutic methods for treating brain disorders, drug delivery to the brain has been challenging because of a very complex Blood Brain Barrier, which precludes most drugs from entering the brain in effective concentrations. Nano-carrier-based drug delivery systems have been reported widely by researchers to overcome this barrier layer. These systems due to their small size, offer numerous advantages; however, their short residence time in the body owing to opsonization hinders their success in vivo. This review article focuses on the various aspects of modifying the surfaces of these nano-carriers with polymers, surfactants, protein, antibodies, cell-penetrating peptides, integrin binding peptides and glycoproteins such as transferrin & lactoferrin leading to enhanced residence time, desirable characteristics such as the ability to cross the blood-brain barrier (BBB), increased bioavailability in regions of the brain and targeted drug delivery.

MRI-based radiomics analysis in differentiating solid non-small-cell from small-cell lung carcinoma: a pilot study

AIM

To investigate the ability of a T2-weighted (W) magnetic resonance imaging (MRI)-based radiomics signature to differentiate solid non-small-cell lung carcinoma (NSCLC) from small-cell lung carcinoma (SCLC).

MATERIALS AND METHODS

The present retrospective study enrolled 152 eligible patients (NSCLC = 125, SCLC = 27). All patients underwent MRI using a 3 T scanner and radiomics features were extracted from T2W MRI. The least absolute shrinkage and selection operator (LASSO) logistic regression model was used to identify the optimal radiomics features for the construction of a radiomics model to differentiate solid NSCLC from SCLC. Threefold cross validation repeated 10 times was used for model training and evaluation. The conventional MRI morphology features of the lesions were also evaluated. The performance of the conventional MRI morphological features, and the radiomics signature model and nomogram model (combining radiomics signature with conventional MRI morphological features) was evaluated using receiver operating characteristic (ROC) curve analysis.

RESULTS

Five optimal features were chosen to build a radiomics signature. There was no significant difference in age, gender, and the largest diameter. The radiomics signature and conventional MRI morphological features (only pleural indentation and lymph node enlargement) were independent predictive factors for differentiating solid NSCLC from SCLC. The area under the ROC curves (AUCs) for MRI morphological features, and the radiomics model, and nomogram model was 0.69, 0.85, and 0.90 (ROC), respectively.

CONCLUSIONS

The T2W MRI-based radiomics signature is a potential non-invasive approach for distinguishing solid NSCLC from SCLC.

Amelioration of oxidative stress utilizing nanoemulsion loaded with bromocriptine and glutathione for the management of Parkinson's disease

Parkinson's disease (PD) is triggered by the formation of free radicals in dopaminergic neurons, which results in oxidative stress-induced neurodegeneration. The objective of the work was to relieve oxidative stress by employing intranasal delivery of Bromocriptine Mesylate (BRM) and Glutathione (GSH) loaded nanoemulsion for the better management of PD. The depth of permeation of the nanoemulsion was assessed through confocal laser scanning microscopy (CLSM) which revealed higher nanoemulsion permeation in contrast to suspension. Biocompatibility of nanoemulsion was confirmed by nasal cilio toxicity study. The DPPH study showed that the nanoemulsion had significant antioxidant activity. Biochemical estimation studies in Wistar rats were carried out in order to determine the effect of nanoemulsion on oxidative stress. The levels of GSH, superoxide dismutase (SOD), and catalase (CAT) were significantly enhanced; and the level of thiobarbituric acid reactive substances (TBARS) was significantly reduced after the intranasal administration of nanoemulsion in the haloperidol-induced model of PD. Furthermore, the levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) were also determined which reduced significantly after the administration of nanoemulsion. The oxidative stress levels were lowered with nanoemulsion, showing the combined antioxidant capability of BRM and GSH. The neuroprotective effect of the prepared nanoemulsion was confirmed by histopathological studies. Pharmacokinetic study revealed a higher concentration of BRM and GSH in the brain of Wistar rats after intranasal administration of nanoemulsion with a higher Brain/Plasma ratio. A higher value of AUC_(0-8) of nanoemulsion in the brain after intranasal administration revealed that BRM and GSH remained in the brain for a longer period due to sustained release from nanoemulsion. According to the findings, BRM and GSH loaded nanoemulsion has the potential to provide a combined and synergistic anti-oxidant effect for efficient management of PD.

In vitro & In vivo evaluations of PLGA nanoparticle based combinatorial drug therapy for Baclofen and Lamotrigine for neuropathic pain management

AIM

Baclofen and Lamotrigine via PLGA nanoparticles were developed for nose-to-brain delivery for treatment of Neuropathic pain.

METHODS

Nanoparticles were prepared using modified nano-precipitation method. The prepared NPs were characterized and further in vitro and in vivo studies were performed.

RESULTS

The Bcf-Ltg-PLGA-NPs were ∼177.7nm with >75%(w/w) drugs encapsulated. In vitro dissolution studies suggested zero-order release profiles following Korsmeyer-Peppas model. In vitro cytotoxicity and staining studies on mammalian cells showed dose dependant cytotoxicity where nanoparticles were significantly less toxic(>95% cell-viability). ELISA studies on RAW-macrophages showed Bcf-Ltg-PLGA-NPs as potential pro-inflammatory-cytokines inhibitor. In vivo gamma-scintigraphy studies on rats showed intra-nasal administration of ^99mTc-Bcf-Ltg-PLGA-NPs showed C_max 3.6%/g at T_max=1.5h with DTE% as 191.23% and DTP% = 38.61% in brain. Pharmacodynamics evaluations on C57BL/6J mice showed significant reduction in licks/bites during inflammation induced phase II pain.

CONCLUSION

The findings concluded that combination of these drugs into single nanoparticle-based formulation has potential for pain management.

Advances in Delivery of Chemotherapeutic Agents for Cancer Treatment

Presently, most of the treatment strategies for cancer are focused on the surgical removal of cancerous tumors, along with physical and chemical treatment such as radiotherapy and chemotherapy, respectively. The primary issue associated with these methods is the inhibition of normal cell growth and serious side effects associated with systemic toxicity. The traditional chemotherapeutics which were delivered systemically were inadequate and had serious dose limiting side effects. Recent advances in the development of chemotherapeutics have simultaneously paved the way for efficient targeted drug delivery. Despite the advances in the field of oncogenic drugs, several limitations remain, such as early blood clearance, acquired resistance against cytotoxic agents, toxicity associated with chemotherapeutics, and site-specific drug delivery. Hence, this review article focuses on the recent scientific advancements made in different types of drug delivery systems, including, organic nanocarriers (polymers, albumins, liposomes, and micelles), inorganic nanocarriers (mesoporous silica nanoparticles, gold nanoparticles, platinum nanoparticles, and carbon nanotubes), aptamers, antibody-drug conjugates, and peptides. These targeted drug delivery approaches offer numerous advantages such as site-specific drug delivery, minimal toxicity, better bioavailability, and an increased overall efficacy of the chemotherapeutics. Graphical abstract.

Advances in microneedle-based transdermal delivery for drugs and peptides

Transdermal drug delivery is a viable and clinically proven route of administration. This route specifically requires overcoming the mechanical barrier provided by the Stratum Corneum of epidermis and vascular and nervous networks within the dermis. First-generation Transdermal patches and second-generation iontophoretic patches have been translated into commercial clinical products successfully. The current review reports different studies that aim to enhance the transdermal delivery of biopharmaceutical using microneedles and their effect on drug delivery. Microneedles (MN) are the micron-scale hybrid between transdermal patches and hypodermic syringes. Microneedles are tested and proven to show better delivery of the drugs, overcoming the drawbacks of hypodermic syringes. Multiple microneedles designs have been fabricated i.e. solid, coated, hollow, and polymer microneedles. Hollow microneedles are shorter in length but similar to hypodermic needles and have pore for infusion of liquid formulation of the drug. Solid microneedles a patch is applied after creating a hole in the skin; Drugs are coated on the surface of Coated microneedles; Polymer microneedles can be of different types like dissolving, non-dissolving or hydrogel-forming made up of polymers. Various advantages and limitations associated with the use of these techniques are discussed. Delivery of peptide and protein molecules with microneedles represents a significant opportunity for a better clinical outcome and hence value creation compared to standard injectable routes of administration. The advancement in various formulation and microfabrication techniques are currently being focused to aid the delivery of protein drugs via microneedles. The most recent advances and limitations in Microneedles -mediated protein and peptide delivery were discussed.

Development and Evaluation of Nanoemulsions for Phenytoin Drug Loading

Aims: To understand about the nanoemulsion types and the process formation of spontaneous emulsification method by phase inversion. Then to test the different combinations of Oil, Surfactants and Co-surfactants for formation of suitable nanoemulsions for phenytoin drug loading. Study Design: Spontaneous emulsification method by phase inversion used to form the nanoemulsions. Place and Duration of Study: Department of Pharmaceutical Sciences, Kumaun University, Nainital, Uttarakhand, India. Methodology: Phenytoin is a widely used drug in anticonvulsants class for epilepsy which comes under BCS Class II of drug category. Phenytoin has high permeability property but it also shows low solubility property which makes it difficult to absorb from GI tract hence make a poor penetration into the brain to target disease in the CNS. To overcome the situation of poor delivery of phenytoin, the requirement of nanoparticulate drug delivery as an innovative and effective drug delivery system from nose to brain raised. The objective of our study was to find the best combination of oil and Smix (surfactant and co-surfactant mixture) to form o/w (Oil in Water) nanoemulsions suitable for loading phenytoin drug using spontaneous emulsification method for brain targeting. Results: Based on different compositions of oil (sunflower), surfactants (Tween-20), and co-surfactants (Transcutol P), forty-five test mixtures were made, water titration technique was employed for preparing the pseudo-ternary-phase diagrams. On the basis of these phase diagrams twenty-five phenytoin loaded nanoemulsions were formulated and further examined. After physicochemical characterization of these formulations the viscosity, pH, RI and % transmittance was found (6.149 ± 0.084 to 9.114 ± 0.027), (6.546 ± 0.018 to 6.656 ± 0.017), (1.395 ± 0.003 to 1.41 ± 0.005) and (94.53 ± 1.4% to 95.58 ± 1.2%) respectively. The release rate of phenytoin was found very satisfactory i.e., 98.51 ± 0.25 % to 99.82 ± 0.28 % after 24 hrs. The four formulations showed best release rate had further taken for particle size analysis. The particle size analysis showed that all the properties were in the desired range i.e., droplet size (18.9 to 21.9), zeta potential (-12.4 to -28.8), PDI (0.334 to 0.363). The study shows that the phenytoin loaded nanoemulsion is possible to make by water titration method and shall have a good drug release rate. Conclusion: The nanoemulsion formulations passed through stress testing had also showed good release rate of phenytoin. Also, the other parameters like viscosity, pH, RI and percentage transmittance were in a quit satisfactory range to proceed further with these formulations. The particle size analysis confirms the formation of nanoemultions which had very good drug release rates.

Adamts18 Deficiency Causes Spontaneous SMG Fibrogenesis in Adult Mice

Chronic sclerosing sialadenitis of the submandibular gland (also known as Küttner tumor) is characterized by concomitant swelling of the submandibular glands secondary to strong lymphocytic infiltration and fibrosis. The pathogenesis of this disease has been unclear, but it is associated with immune disorders. ADAMTS18 is a member of the ADAMTS superfamily of extracellular proteinases. In this study, we showed that Adamts18 is highly expressed in submandibular salivary gland (SMG) during embryonic development and decreases but is retained in adult SMG tissue in mice. Adamts18 deficiency led to reduced cleft formation and epithelial branching in embryonic SMG before embryonic day 15.5 in mice. No significant histologic changes in the later stages of branching or the morphology of SMG were detected in Adamts18^-/- mice. However, Adamts18 deficiency causes spontaneous SMG fibrogenesis and fibrosis in adult mice. At 8 wk of age, Adamts18^-/- mice began to manifest the first signs of pathologic changes of mild fibrosis and CD11b⁺ cell infiltration in SMG tissues. At ≥8 mo, all male and female Adamts18^-/- mice developed unilateral or bilateral SMG scleroma that is similar to patients with chronic sclerosing sialadenitis of the submandibular gland. Adamts18^-/- mice also showed secretory dysfunction and severe dental caries. Histologically, SMG scleroma is characterized by progressive periductal fibrosis, acinar atrophy, irregular duct ectasis, and dense infiltration of IgG-positive plasma cells. A significant infiltration of CD4⁺ T lymphocytes and CD11b⁺ monocytes and macrophages was also detected in the SMG scleroma of Adamts18^-/- mice. The levels of TGF-β1, IL-6, and IL-33 were significantly increased in Adamts18^-/- SMGs, which induces chronic inflammation and myofibroblast activation, ultimately leading to fibrosis. This study indicates that Adamts18 regulates the early branching morphogenesis of embryonic SMG and plays a role in protecting from spontaneous SMG fibrogenesis via modulating local inflammation, autoimmune reaction, and myofibroblast activation in adult mice.

Anti-cancer potential of some commonly used drugs

Cancer is a global concern leading to millions of deaths every year. A declining trend in new drug discovery and development is becoming one of the major issues among the pharmaceutical, biotechnology industries, and regulatory agencies. New drug development is proven to be a very lengthy and costly process. The launch of a new drug takes 8-12 years and huge investments. The success rate in oncology therapeutics is also low due to toxicities at the pre-clinical and clinical trial levels. Many oncological drugs get rejected at a very promising stage, showing adverse reactions on healthy cells. Thus, exploring new therapeutic benefits of the existing, shelved drugs for their anti-cancerous action could result in a therapeutic approach preventing the toxicities which occur during clinical trials. Drug repurposing has the potential to overcome the challenges faced via conventional way of drug discovery and is becoming an area of interest for researchers and scientists. However, very few in vivo studies are conducted to prove the anti-cancerous activity of the drugs. Insufficient in vivo animal studies and a lack of human clinical trials are the lacunae in the field of drug repurposing. This review focuses on an aspect of drug repurposing for cancer therapeutics. Various studies that show that drugs approved for clinical indications other than cancer have shown promising anti-cancer activities. Some of the commonly used drugs like Benzodiazepines (Diazepam, Midzolam), Antidepressants (Imipramine, Clomipramine, and Citalopram), Antiepileptic (Valporic acid, Phenytoin), Antidiabetics (metformin), etc. have been reported to show potential activity against the cancerous cells.

Effect of radiomics from different virtual monochromatic images in dual-energy spectral CT on the WHO/ISUP classification of clear cell renal cell carcinoma

AIM

To investigate the effect of radiomics obtained from different virtual monochromatic images (VMIs) in dual-energy spectral computed tomography (CT) on the World Health Organization/International Association for Urological Pathology (WHO/ISUP) classification of clear cell renal cell carcinoma (ccRCC).

MATERIALS AND METHODS

A retrospective study of 99 ccRCC patients who underwent contrast-enhanced dual-energy CT was undertaken. ccRCC was confirmed at surgery or biopsy and graded according to the WHO/ISUP pathological grading criteria as low grade (n=68, grade I and II) or high grade (n=31, grade III and IV). Radiomics risk scores (RRSs) for differentiating high and low grades of ccRCC were constructed from 11 sets of VMI in (40-140 keV, 10 keV interval) the cortical phase. Receiver operating characteristic (ROC) curves were drawn and the area under the curves (AUCs) was calculated to evaluate the discriminatory power of RRS for each VMI. The Hosmer-Lemeshow test was used to evaluate the goodness-of-fit of each model and the decision curve was used to analyse its net benefit to patients.

RESULTS

The AUC values for distinguishing low-from high-grade ccRCC with RRS of 40-140 keV VMIs were all >0.920. The Hosmer-Lemeshow test showed that the p-values of RRS of VMIs were >0.05, suggesting good fits. In the decision curve analysis, RRS from the 40-140 keV VMIs had similar decision curves and provided better net benefits than considering all patients either as high-grade or low-grade.

CONCLUSIONS

The RRS obtained from multiple VMIs in dual-energy spectral CT have high diagnostic efficiencies for distinguishing between low- and high-grade ccRCC with no significant differences between different VMIs.

CHARACTERIZATION OF ANTIMICROBIAL SUBSTANCE WITH ANTIBIOFILM ACTIVITY FROM Pediococcus acidilactici

Objective: The aim of the current study was to isolate and identify the strain having broad spectrum antibacterial and antibiofilm activity and characterize its antimicrobial substance. Methods: Lactic acid bacteria isolated from the raw milk of Indian goat species Babri and Sirohi (Capra aegagrus hircus) were screened for antibacterial activity against Staphylococcus epidermidis, Micrococccus luteus, Pseudomonas fluorescens and Escherichia coli. The selected strains were also analysed for anti-biofilm activity on S. epidermidis. The potential bacterial strain was characterized at molecular level by 16S rDNA sequencing. The antimicrobial substance produced by P. acidilactici was precipitated by 90% ammonium sulphate and subsequently ultra filtered. It was analysed for size, stability under various pH, temperature, chemicals and enzymatic conditions. Its mechanism of killing was determined by ML35p assay and scanning electron microscopy (SEM). Results: The 16S rDNA sequence of the potential isolate, possessing broad spectrum antibacterial activity and antibiofilm activity against S. epidermidis, was deposited to Genbank under accession no. KP671843 and was identified as Pediococcus acidilactici. The partially purified bacteriocin ran at approximately 3500 Da on tris- tricine SDS-PAGE and showed antibacterial activity against S. epidermidis by In-gel assay. Partially purified bacteriocin was stable at wide pH and high temperature and also to the treatment of lipase, amylase, catalase and various detergents/organic solvents. However, it was sensitive to proteolytic enzymes indicating its proteinaceous nature. Results of membrane permeability assay revealed that the bacteriocin targets bacterial cell membrane as its bactericidal action. Conclusion: The bacteriocin from P. acidilactici has the potential to be used as broad spectrum antibacterial and antibiofilm agent.

Synthesis of silver nanoparticles using Lactobacillus bulgaricus and assessment of their antibacterial potential

Many pathogenic strains have acquired multidrug-resistant patterns in recent a year, which poses a major public health concern. The growing need for effective antimicrobial agents as novel therapies against multidrug-resistant pathogens has drawn scientist attention toward nanotechnology. Silver nanoparticles are considered capable of killing multidrug-resistant isolates due to their oligo-dynamic effect on microorganisms. In this research study NPs were synthesized using the gram-positive bacteria Lactobacillus bulgaricus and its activity against selected pathogenic strains. Lactobacillus bulgaricus pure cultures were isolated from raw milk and grown in "De Man, Rogasa, and Sharp" broth for synthesis of nanoparticles. Lactobacillus bulgaricus culture was centrifuged and Cell- free supernatant of it was employed with aqueous silvery ions and evaluated their antibacterial activities against bacterial strains i.e. Staphylococcus aureus, Staphylococcus epidermidis and Salmonella typhi using agar well diffusion assay. Antibiotic profiling against selected pathogenic strains were also conducted using disc diffusion method. The synthesis and characterization of silver nanoparticles were monitored primarily by the conversion of the pale-yellow color of the mixture into a dark-brown color and via ultraviolet-visible absorption spectroscopy and Scanning electron microscopy respectively. The result showed that that AgNPs with size (30.65-100 nm) obtained from Lactobacillus bulgaricus were found to exhibit antibacterial activities against selected bacterial strains. Taken together, these findings suggest that Lactobacillus bulgaricus has great potential for the production of AgNPs with antibacterial activities and highly effective in comparison to tested antibiotics.

Replacing true unenhanced imaging in renal carcinoma with virtual unenhanced images in dual-energy spectral CT: a feasibility study

AIM

To investigate the clinical value of virtual unenhanced (VNC) spectral computed tomography (CT) images to replace the conventional true unenhanced spectral CT images (TNC) in diagnosing renal carcinoma.

MATERIALS AND METHODS

Fifty-six cases of renal carcinoma confirmed by histopathology underwent conventional plain CT and contrast-enhanced spectral CT at arterial phase (AP) and venous phase (VP). VNC images were generated on an AW4.6 workstation. The CT attenuation, image noise, contrast-to-noise ratio (CNR), and signal-noise-ratio (SNR) of the renal lesions and normal kidneys, long and short axis diameters of the lesion were measured from the three image sets and analysed using one-way analysis of variance (ANOVA). Two radiologists evaluated image quality subjectively using a five-point score, and lesion signature using a three-point score. Image quality scores were compared statistically and tested for consistency.

RESULTS

The two reviewers had good agreement for subjective evaluation (Kappa>0.70) and there was no difference in the quality of the scores among the three image groups. The lesion signature scores were all above the acceptable level. The CNR and SNR values in VNC were significantly higher than in TNC (p<0.05). VNC images had lower renal noise than in TNC (p<0.05). There was no difference in the long and short axis diameters of the lesion among the three image groups. VNC had higher CT attenuation values for the lesion and kidney than TNC (p<0.05), but the differences were <5 HU.

CONCLUSION

VNC images in spectral CT may be used to replace the conventional plain CT to reduce imaging duration and radiation dose in diagnosing renal carcinoma.

Synergistic antibacterial and anti-biofilm activity of nisin like bacteriocin with curcumin and cinnamaldehyde against ESBL and MBL producing clinical strains

Bacteriocins are small peptides that can inhibit the growth of a diverse range of microbes. There is a need to identify bacteriocins that are effective against biofilms of resistant clinical strains. The present study focussed on the efficacy of purified nisin like bacteriocin-GAM217 against extended spectrum β-lactamase (ESBL) and metallo-beta-lactamase (MBL) producing clinical strains. Bacteriocin-GAM217 when combined with curcumin and cinnamaldehyde, synergistically enhanced antibacterial activity against planktonic and biofilm cultures of Staphylococcus epidermidis and Escherichia coli. Bacteriocin-GAM217 and phytochemical combinations inhibited biofilm formation by >80%, and disrupted the biofilm for selected ESBL and MBL producing clinical strains. The anti-adhesion assay showed that these combinatorial compounds significantly lowered the attachment of bacteria to Vero cells and that they elicited membrane permeability and rapid killing as viewed by confocal microscopy. This study demonstrates that bacteriocin-GAM217 in combination with phytochemicals can be a potential anti-biofilm agent and thus has potential for biomedical applications.

Memantine nanoemulsion: a new approach to treat Alzheimer's disease

Aim: A nanoemulsion loaded with memantine for intranasal delivery to bypass the blood-brain barrier for the treatment of Alzheimer disease.Method: The nanoemulsion was prepared using homogenisation and ultrasonication methods. The developed nanoemulsion was characterised, in vitro release and antioxidant potential was analysed. The in vivo studies were carried out by radiolabelling the memantine with technetium pertechnetate.Results: The finalised NE showed particle-size of ∼11 nm and percentage transmittance of ∼99%. The in vitro release studies showed 80% drug release in simulated nasal fluid. The nanoemulsion showed 98% cell viability and antioxidative assays confirmed that the encapsulation of memantine in a nanoemulsion sustained its antioxidative potential. Gamma images and biodistribution results also confirmed higher uptake of formulation with %radioactivity of 3.6 ± 0.18%/g at 1.5 h in brains of rats administered intranasally.Conclusion: The developed nanoemulsion could be used as a potential carrier of memantine for a direct nose to brain delivery.

Treatment of Alzheimer's diseases using donepezil nanoemulsion: an intranasal approach

Alzheimer disease (AD) is very common among the older people. There are few medications available as oral and suspension dosage forms for the management of AD. Due to the rising cases of AD and the associated risks of the existing line of treatment, oil in water (o/w) nanoemulsion (NE) loaded with donepezil was prepared to explore intranasal route of administration. The NE was prepared using labrasol (10%), cetyl pyridinium chloride (1% in 80% water), and glycerol (10%), with a drug concentration of 1 mg/ml. The developed NE was characterized for particle size, polydispersity index (PDI), and zeta potential. In vitro release studies were conducted to observe the release of drug. Further in vivo studies of developed NE were done on Sprague Dawley rats using technetium pertechnetate (^99mTc) labeled formulations to investigate the nose to brain drug delivery pathway. The nanoemulsion showed particle size of 65.36 nm with a PDI of 0.084 and zeta potential of -10.7 mV. In vitro release studies showed maximum release of 99.22% in 4 h in phosphate-buffered saline, 98% in 2 h in artificial cerebrospinal fluid, and 96% in 2 h in simulated nasal fluid. The cytotoxicity and antioxidant activity of the NE showed dose-dependent cytotoxicity and % radical scavenging activity (%RSA). The images of giemsa staining also confirmed that the developed formulation has no impact on the morphology of cells. Scintigrams showed maximum uptake of NE in the brain. The findings suggested that the developed NE loaded with donepezil hydrochloride could serve as a new approach for the treatment of Alzheimer via nose to brain drug delivery. Graphical abstract.

Nose-to-brain delivery of lamotrigine-loaded PLGA nanoparticles

Direct nose-to-brain delivery of drugs and faster onset of action have made intra-nasal route a much sought-after alternative to conventional routes of drug delivery to the brain. Lamotrigine is used for the treatment and management of neuropathic pain, and in the present work, lamotrigine (LTG)-PLGA nanoparticles were developed for intra-nasal delivery. The LTG-PLGA nanoparticles were prepared using modified nanoprecipitation method via high-speed homogenization and ultra-sonication techniques. Entrapment efficiency (EE%) of developed LTG-PLGA-NPs was found to be 84.87 ± 1.2% with drug loading of 10.21 ± 0.89%. The particle size of developed nanoparticles was found to be 184.6 nm with PDI value of 0.082 and zeta potential of - 18.8 mV. Dissolution profiles were studied in PBS (pH 7.4), simulated nasal fluid, and simulated cerebrospinal fluid where almost complete release was observed within 5 h in CSF. In vitro, cytotoxicity was analyzed using MTT assay where dose-dependent cytotoxicity was observed for developed LTG-PLGA-NPs. In vitro cytokine analysis showed positive effects of LTG-PLGA-NPs as pro-inflammatory cytokine suppressors. Further, in vivo studies were performed for radiolabeled formulation and drug (^99mTc-LTG-PLGA-NPs and ^99mTc-LTG-aqueous) using Sprague Dawley rats where with the help of gamma scintigraphy studies, various routes of administration viz. oral, intra-nasal, and intra-venous were compared. Various pharmacokinetic parameters were evaluated using biodistribution studies to estimate the drug levels in blood and brain. For ^99mTc-LTG-PLGA-NPs via intra-nasal route, drug targeting efficiency (DTE%) was found to be 129.81% and drug target organ transport (DTP%) to be 22.81% in brain with C_max of 3.82%/g within T_max 1.5 h. Thus, the developed PLGA nanoparticles for intra-nasal delivery provide a possible alternative for existing available drug formulation for neuropathic pain management.

Neuropsychological Disorders and their Nanocarriers

Neuropsychological disorders are now growing rapidly worldwide among the people of diverse backgrounds irrespective of age, gender, and geographical region. Such disorders not only disturb the normal life and functionality of an individual but also impact the social relationships of the patient and the people associated with them, and if not treated in time, it may also result in mortality in severe conditions. Various antipsychotic drugs have been developed but their use is often limited by issues related to effective drug delivery at the site of action i.e. brain, mainly because of the blood-brain barrier. To resolve these issues, researchers and scientists have been working to develop a more effective drug delivery system where drugs can cross the blood-brain barrier and reach the brain in more effective concentrations. Drugs have been modified and formulated into nano-carriers and experimental studies for efficient and targeted delivery of drugs have been conducted. This review focuses on certain common neuropsychological diseases and their nanocarriers developed for drug delivery in the brain and are discussed with a brief description of various experimental in vitro and in vivo studies. This review also focuses on the intranasal route for the delivery of antipsychotic drugs and constraints faced due to the blood-brain barrier by the drugs.

Piezoelectric modulation of broadband photoresponse of flexible tellurium nanomesh photodetectors

Flexible photodetector shows great potential applications in intelligent wearable devices, health monitoring, and biological sensing. In this work, single crystal β-tellurium nanowires were grown on flexible muscovite by molecular beam epitaxy, constructing high-density ordered nanomesh structure. The prepared photodetectors based on tellurium nanomesh exhibit excellent mechanical flexibility, fast response in a broad range from ultraviolet to near-infrared, and good photosensitivity. We found that the flexible photodetectors with Shottky contact drastically suppressed dark current, while the response speed was lowered in comparison to the devices with ohmic contact, as holes would take a long time to tunnel through the Shottky barrier between metal and p-type Te. Moreover, the photoresponse of flexible Shottky photodetectors can be modulated by piezoelectricity of tellurium, and pronounced photocurrent increase after bending many times. Under external stress, polarization charges could tune Shottky barrier height of the metal/tellurium, resulting in variation of photocurrent. This research not only explores the broadband photoresponse and piezoelectric effect of tellurium nanomesh, but also promotes the integration and development of broadband flexible optoelectronic devices.

Nanoemulsions of Green Tea Catechins and Other Natural Compounds for the Treatment of Urinary Tract Infection: Antibacterial Analysis

Purpose: Nanoemulsions (NEs) of polyphenon 60 (P60) and cranberry (NE I) and P60 and curcumin (NE II) were prepared with the aim to enhance anti-bacterial potential and to understand the mechanism of anti-bacterial action of the encapsulated compounds. Methods: To evaluate the antibacterial potential of the developed NE, microtiter biofilm formation assay was performed. The cytotoxicity analysis was done to assess the toxicity profile of the NEs. Further antibacterial analysis against uropathogenic strains was performed to check the developed NEs were effective against these strains. Results: In microtiter dish biofilm formation assay, both NE formulations inhibited the growth more effectively (Av. % inhibition ~84%) as compared to corresponding aqueous solution (Av. % inhibition ~64%) and placebo (Av. % inhibition ~59%) at their respective minimum inhibitory concentration (MIC) values. Cytotoxicity analysis using 3-(4,5-Dimethylthiazol-2-yl)- 2,5-diphenyltetrazolium bromide (MTT assay) showed that the formulations were nontoxic to Vero cells. The antibacterial studies against uropathogenic resistant strains also showed that NEs effectively inhibited the growth of bacterial strains. Conclusion: From different studies it was concluded that both the NE's were able to inhibit bacterial strains and could be further used for the treatment of urinary tract infection (UTI). The antibacterial activity of developed NEs showed that these could be used as alternative therapies for the treatment of UTI.

Baclofen-Loaded Poly (D,L-Lactide-Co-Glycolic Acid) Nanoparticles for Neuropathic Pain Management: In Vitro and In Vivo Evaluation

In this work, poly (D,L-lactide-co-glycolic acid) (PLGA) nanoparticles of baclofen (Bcf-PLGA-NPs) were developed and optimized using nanoprecipitation method. The average particle size of the Bcf-PLGA-NP was found to be 124.8 nm, polydispersity index of 0.225, and zeta potential was found to be in the range of -20.4 mV. In vitro dissolution studies showed that Bcf was released from PLGA NPs in a sustained manner from 50% release in 2.5 hours to 80%-85% in 24 hours. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay on Neuro-2a neuroblastoma cell line showed comparably low cytotoxicity of Bcf-PLGA-NPs as compared with aqueous solution of Bcf at reported C_max values of the drug. To explore the nose-to-brain pathway, in vivo studies were carried out in Sprague-Dawley rats by radiolabeling of Bcf with technetium-99m (^99mTc). Gamma scintigraphy images of the rats that were administered through intranasal (i.n.) route showed the maximum uptake of radiolabeled NPs from nose to brain at 3 hours as compared with the rats administered with NPs intravenously and orally. To assess the Bcf concentration in brain and blood, biodistribution studies were performed and following i.n. route the NPs were dispersed in brain (3.5%/g) and blood (3%/g) at 3 hours, and these observations were in agreement with the gamma scintigrams. Hence, from the results it was suggested that the developed PLGA NPs could serve as a potential carrier for the Bcf in the treatment of neuropathic pain.

Selegiline Nanoformulation in Attenuation of Oxidative Stress and Upregulation of Dopamine in the Brain for the Treatment of Parkinson's Disease

Objective of this study was to determine whether the prepared nanoemulsion would be able to deliver selegiline to the brain by intranasal route, improving its bioavailability. Antioxidant activity, pharmacokinetic parameters, and dopamine concentration were determined. Oxidative stress models, which had Parkinson's disease-like symptoms, were used to evaluate the antioxidant activity of nanoemulsion loaded with selegiline in vivo. The antioxidant activity was evaluated by 1,1-diphenyl-2-picryl-hydrazyl (DPPH) assay and reducing power assay, which showed high scavenging efficiency for selegiline nanoemulsion compared to pure selegiline. Biochemical estimation results showed that the levels of antioxidant enzymes, including glutathione and superoxide dismutase, were increased, whereas the levels of thiobarbituric acid-reactive substances were decreased in intranasally administered selegiline nanoemulsion-treated group when compared with haloperidol-induced Parkinson's disease group (control). Moreover, selegiline nanoemulsion was found to be successful in decreasing the dopamine loss, indicating that nanoemulsion is a potential approach for intranasal delivery of selegiline to decrease the damage due to free radicals, thus avoiding consequent biochemical alterations that arise during Parkinson's disease. Brain:blood ratio of 2.207 > 0.093 of selegiline-loaded nanoemulsion (intranasally administered) > selegiline solution (administered intravenously), respectively, at 0.5 hours showed direct nose-to-brain delivery of drug bypassing blood-brain barrier. Selegiline-loaded nanoemulsion administered intranasally showed significantly high dopamine concentration (16.61 ± 3.06 ng/mL) compared to haloperidol-treated rats (8.59 ± 1.00 ng/mL) (p < 0.05). In this way, intranasal delivery of selegiline nanoemulsion might play an important role in the better management of Parkinson's disease.

Systematic review with meta-analysis: effectiveness and tolerability of interferon-free direct-acting antiviral regimens for chronic hepatitis C genotype 1 in routine clinical practice in Asia

BACKGROUND

Direct-acting antiviral (DAA) regimens have shown high efficacy and tolerability for patients with HCV genotype 1/1b (GT1/1b) in clinical trials. However, robust real-world evidence of interferon (IFN)-free DAA treatment for HCV GT1-infected patients in Asia is still lacking.

AIM

To systematically review and meta-analyse the effectiveness and tolerability of IFN-free DAA therapy for HCV GT1 infection in Asia.

METHODS

We included studies that enrolled adult patients with HCV GT1 infection in routine clinical practice in Asia, using IFN-free DAA regimens, and reported sustained virological response (SVR) after 12/24 weeks end-of-treatment by 31 May 2017. The pooled SVR rates were computed with a random-effects model. Subgroup analysis and meta-regression as previously registered in PROSPERO were performed to determine how pre-planned variables might have affected the pooled estimates.

RESULTS

We included 41 studies from eight countries and regions, comprising of 8574 individuals. The pooled SVR rates for GT1 were 89.9% (95% CI 88.6-91.1, I²  = 55.1%) with daclatasvir/asunaprevir (DCV/ASV) and 98.1% (95% CI 97.0-99.0, I²  = 41.0%) with ledipasvir/sofosbuvir ± ribavirin (LDV/SOF ± RBV). Baseline cirrhosis but not prior treatment history and age, attenuated the effectiveness of both regimens. Baseline resistance associated substitutions (RASs) severely attenuated SVR of DCV/ASV (65.4% vs 94.3%, P < 0.001) and only minimally with LDV/SOF ± RBV (94.5% vs 99.2%, P = 0.003). Patients with renal dysfunction treated with DCV/ASV showed a higher SVR rate (93.9% vs 89.8%, P = 0.046). Patients with hepatocellular carcinoma (HCC) LDV/SOF ± RBV achieved a lower SVR than those without HCC (94.1% vs 98.7%, P = 0.001).

CONCLUSION

All oral DAA treatment of HCV GT1 resulted in high cure rates in Asian patients in routine clinical practice setting including elderly patients and those with end-stage renal disease.

Antibacterial Activity, Cytotoxicity, and the Mechanism of Action of Bacteriocin from Bacillus subtilis GAS101

OBJECTIVE

The aim of this study was to purify and characterize bacteriocin from the soil isolate Bacillus subtilis GAS101, and to determine its antimicrobial as well as antibiofilm potential. The purified bacteriocin was further analyzed and evaluated for mammalian cell cytotoxicity and the possible mode of action.

MATERIAL AND METHODS

Bacteriocin from B. subtilis GAS101 (an animal husbandry soil isolate) was partially purified and checked for antimicrobial and antibiofilm activity against gram-positive and gram-negative bacteria. The molecular weight of bacteriocin was determined using tricine SDS-PAGE gel. The stability of bacteriocin was investigated at various temperatures and pH levels, and its sensitivity towards 8 enzymes and 6 chemicals was determined. Cytotoxicity analysis was performed on a Vero cell line by a tetrazolium dye-based assay. Scanning electron microscopy (SEM) of bacteriocin-treated bacteria was carried out to determine the possible mode of action.

RESULTS

Bacteriocin from B. subtilis GAS101 was a potential inhibitor of both the indicator organisms (Staphylococcus epidermidis and Escherichia coli), and had a molecular weight of approximately 6.5 kDa. An in situ gel assay showed a zone of inhibition corresponding to the estimated protein band size. Bacteriocin was stable and showed antibacterial activity in broad ranges of temperature (30-121°C) and pH (2-12). It was sensitive to 4 proteolytic enzymes, which indicated its proteinaceous nature. Bacteriocin showed > 70% cell viability on the mammalian Vero cell line. SEM depicted that the bacteriocin was able to disrupt the bacterial cell membrane as its probable mode of action.

CONCLUSION

Thermostable and pH-tolerant bacteriocin from B. subtilis GAS101, of about 6.5 kDa, showed broad-spectrum antimicrobial and antibiofilm activity.

Development of Nanoemulsion Based Gel Loaded with Phytoconstituents for the Treatment of Urinary Tract Infection and in Vivo Biodistribution Studies

Purpose: A nanoemulsion based gel containing Polyphenon 60 (P60) and cranberry (CRB) has been developed to deliver via intravaginal route for the treatment of urinary tract infection.

Methods: Polyphenon 60 and cranberry were loaded in a single nanoemulsion gel (NBG) by ultra-sonication method and characterized for particle size, rheological properties, in vitro release and growth curve analysis. P60+CRB NBG were radiolabelled using technetium pertechnetate (^99mTc) to perform in vivo pharmacokinetic studies in animals.

Results: The finalized NE had a droplet size of 58±1 nm. In vitro release of 90.92 ± 0.6% in 8 hr for P60 and 99.39 ± 0.5% in 6 hr for CRB was observed in simulated vaginal fluid. Growth curve of E. coli indicated the inhibitory action of nanoemulsion based gel at the fifth hour of inoculation. Gamma scintigraphy studies on female Sprague-Dawley rats showed transport of nanoemulsion based gel from the vaginal cavity into the systemic circulation. Further, biodistribution studies with radiolabelled P60+CRB NBG showed significant higher uptake of radiolabelled actives by kidney (3.20±0.16) and urinary bladder (3.64±0.29), when administered intravaginally.

Conclusion: The findings suggested ^99mTc-P60+CRB NBG can potentially be transported through vaginal cavity and reach the target organs and showed effective distribution in organs affected in urinary tract infection

Intravaginal Delivery of Polyphenon 60 and Curcumin Nanoemulsion Gel

Polyphenon 60 (P60) and curcumin (CUR) were loaded in a single nanoemulsion system and their combined antibacterial action was studied against uropathogenic Escherichia coli. To enhance availability at target organs and to inhibit enzymatic degradation in gastro intestinal tract, vaginal route of administration was explored. P60 + CUR nanoemulsion (NE) was formulated by ultra-sonication and optimized using Box-Behnken design. Optimized NE showed Z-average of 211.2 nm, polydispersity index of 0.343, and zeta potential of -32.7 mV. Optimized P60+ CUR NE was characterized by stability testing and transmission electron microscopy, and it was observed that NE was stable at 4°C for 30 days and monodisperse in nature with particle size of 195-205 nm. P60+ CUR NE was further formulated as gel and characterized by viscosity, growth curve analysis, and in vitro permeation studies. In vitro drug permeation studies in simulated vaginal media showed maximum permeation (84 ± 0.21%) of curcumin within 5 h and (91 ± 0.16%) of P60 within 8 h. Both the drugs maintained sustained permeation for 12 h. To investigate the transport via intravaginal route, gamma scintigraphy and biodistribution study of P60 + CUR NBG was performed on Sprague-Dawley rats using ^99mtechnetium pertechnetate for radiolabeling to P60 molecule. Following intravaginal administration, P60 + CUR NBG dispersed in the kidney and urinary bladder with (3.07 ± 0.15) and (3.35 ± 0.45) percentage per gram after 3 h for P60 and CUR, respectively, and remained active for 12 h. Scintigraphy images suggested that the P60 + CUR NBG given by intravaginal route led to effective distribution of actives in urinary tract, and this observation was in agreement with the biodistribution results.

Nose to Brain Delivery of Midazolam Loaded PLGA Nanoparticles: In Vitro and In Vivo Investigations

OBJECTIVES

The present study is aimed to develop poly(D, L-lactide-co-glycolic acid) (PLGA) nanoparticles (NP) loaded with midazolam (Mdz) for nose to brain delivery.

MATERIALS AND METHODS

NP were formulated by nanoprecipitation and characterized for z-average, zeta potential, % drug entrapment and ex vivo drug release. Mdz NP (MNP) were radiolabeled with technetium-99m. Biodistribution and gamma scintigraphic studies were performed on Sprague-Dawley rats following intranasal (i.n) and intravenous (i.v) administration to trace the transport of Mdz for nose-to-brain delivery.

RESULTS AND DISCUSSION

MNP showed z-average of 164±4.5nm with polydispersity index 0.099±0.02 and zeta potential of -16.6±2.5mV. Ex vivo drug studies indicated that MNP showed 29±1.2% of permeation upto 4h via sheep nasal mucosa, whereas Mdz suspension (MS) showed drug release of 83±1.2% within 4h. Comparing i.n administration of MNP, MS and i.v administration of MS, scintigraphy imaging and Brain/blood uptake ratios indicated higher brain targeting via i.n administration of MNP.

CONCLUSION

Results indicated that the i.n MNP could be employed as a non invasive mode of delivery system with improved drug entrapment, stability and controlled drug release over a period of time.

Influence of VEGF, COX-2, and MMP-9 expression on the molybdenum-targeted X-ray in breast cancer

AIM

To investigate the correlation of the expression of vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2), and matrix metalloprotease-9 (MMP-9) in breast cancer tissues with molybdenum-targeted X-ray images.

MATERIALS AND METHODS

Sixtynine patients with invasive ductal carcinoma of the breast confirmed by molybdenum-targeted mammography, surgical, and pathologic examinations were enrolled. The expression of VEGF, COX-2, and MMP-9 were detected by immunohistochemical staining (IHS) and the correlation of VEGF, COX-2, and MMP-9 expression and classification of breast cancer on molybdenum-targeted X-ray was statistically analyzed.

RESULTS

The expression of VEGF, COX-2, and MMIP-9 were significantly higher (p < 0.05) in spiculation group (n = 50), vascular abnormalities group (n = 21), and lymph node metastasis group (n = 29),than the other three groups, respectively. However, the expression of VEGF, COX-2, and MMP-9 had no significant differences (p > 0.05) between the group with (n = 30) and without (n = 39) calcification.

CONCLUSION

Expression of VEGF, COX-2, and MMP-9 is highly correlated to the mammaographic appearance of spiculation, vascular abnormalities, and lymph node metastasis. However, the present results suggest that expression of VEGF, COX-2, and MMP-9 is either not or weakly correlated to mammographic appereance of calcification.

Escherichia coli biofilm: development and therapeutic strategies

Escherichia coli biofilm consists of a bacterial colony embedded in a matrix of extracellular polymeric substances (EPS) which protects the microbes from adverse environmental conditions and results in infection. Besides being the major causative agent for recurrent urinary tract infections, E. coli biofilm is also responsible for indwelling medical device-related infectivity. The cell-to-cell communication within the biofilm occurs due to quorum sensors that can modulate the key biochemical players enabling the bacteria to proliferate and intensify the resultant infections. The diversity in structural components of biofilm gets compounded due to the development of antibiotic resistance, hampering its eradication. Conventionally used antimicrobial agents have a restricted range of cellular targets and limited efficacy on biofilms. This emphasizes the need to explore the alternate therapeuticals like anti-adhesion compounds, phytochemicals, nanomaterials for effective drug delivery to restrict the growth of biofilm. The current review focuses on various aspects of E. coli biofilm development and the possible therapeutic approaches for prevention and treatment of biofilm-related infections.

Evaluation of the Antimicrobial Functions of N-halamine Dental Unit Waterline Tubing for One Year

OBJECTIVES

The objective of this study was to test the biofilm-controlling properties of N-halamine antimicrobial dental unit waterline (DUWL) tubing (T) tubing, without recharging over one year, compared to a control line (C).

METHODS

A simulated clinical model was used to pump ultrapure water through T and C lines at a rate of 1.4 mL/min, five minutes on, 15 minutes off, eight hours/day, five days a week. Samples of source water, effluent from T and C, and from the stagnant water in the carboy (liquid container) after bench work was completed (S2), were collected aseptically, serially diluted, and cultured on R2A agar for seven days every six weeks. SEM images of the inside surfaces of detached tubing sections were also taken. The carboy was rinsed with a 1:10 dilution of sodium hypochlorite after six months. Means of log transformed CFU values obtained in triplicate were paired by T and C lines across months for comparison by paired Student's t-tests.

RESULTS

An increase in effluent and carboy bacterial counts were noted after six months, but decreased after bleach rinse of the carboy. No significant difference (p > 0.25) between T and C lines were observed; similarly, T and carboy were not significantly different (p > 0.30). SEM images showed biofilm attachment on the inside surface of C after two months, but not on T. Organisms identified in the effluent reflected those in the source carboy.

CONCLUSIONS

No biofilm attachment was detected on the N-halamine test line after 12 months, indicating its antimicrobial properties were retained. Further evaluation is recommended to determine the optimal recharge interval for N-halamine DUWL tubing when ultrapure source water is used.